Bariatric Surgery and Diabetes: Implications of Type 1 Versus Insulin-Requiring Type 2

Obesity (Silver Spring). 2015 Mar;23(3):552-7. doi: 10.1002/oby.20992. Epub 2015 Jan 22.

Abstract

Objective: To report the impact of bariatric surgery on metabolic outcomes in patients with type 1 diabetes (DM1) versus insulin-requiring type 2 diabetes mellitus (IRDM2).

Methods: Ten subjects with DM1 were compared with 118 subjects with IRDM2 at baseline and at 1 and 2 years post-bariatric surgery for: anthropometric measures, HbA1c, and number of medications (anti-hyperglycemic, anti-hypertensive, lipid-lowering).

Results: DM1 and IRDM2 groups lost similar amounts of weight 2 years post-bariatric surgery (39.5 ± 14.7 kg vs. 40.3 ± 24.4 kg). IRDM2 subjects had significant improvements in HbA1c (7.8% ± 1.4% vs. 6.8% ± 1.4%, P value <0.0001) and decreases in number of anti-hyperglycemic (2.4 ± 0.8 vs. 0.7 ± 0.8, P value <0.0001), anti-hypertensive (2.2 ± 1.3 vs. 1.3 ± 1.2, P value <0.0001), and lipid-lowering (1.1 ± 0.8 vs. 0.6 ± 0.6, P value <0.0001) medications. DM1 subjects had no improvement in HbA1c (8.2% ± 1.6% vs. 7.8% ± 0.9%) or use of anti-hypertensive medications (2.1 ± 1.4 vs. 2.3 ± 1.5). Their use of lipid-lowering medications improved (1.0 ± 0.5 vs. 0.5 ± 0.8, P value 0.04).

Conclusions: Our study suggests that improved glycemic control may not be an expected outcome when considering bariatric surgery in patients with DM1; however, additional investigation is warranted.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anthropometry
  • Bariatric Surgery
  • Blood Glucose / metabolism
  • Body Weight
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Humans
  • Insulin / therapeutic use*
  • Male
  • Middle Aged
  • Postoperative Period
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Blood Glucose
  • Insulin